Digital Commons Network^™

A Theology Of Hope For Missing Persons And Lost Causes, Joelle Yanko

Salubritas: International Journal of Spirit-Empowered Counseling

This paper explores how unresolved tragedies—particularly missing person cases and lost causes—serve as profound reflections of the human condition and reveal the necessity of Christian eschatological hope. Missing person cases touch the deepest questions of the human soul and reveal a deep, universal longing for justice and resolution—longings that cannot be fully met within the bounds of this present life. Drawing from theological reflection, the paper argues that both suffering and miraculous resolution ultimately point toward a greater hope found in the Christian vision of union with God. This future-oriented hope, grounded in the resurrection of Christ, invites believers to …

Exploring Biblical Language In Trauma Processing, Kathy B. Hoppe

Salubritas: International Journal of Spirit-Empowered Counseling

Clients may often find themselves struggling with accessing traumatic experiences in therapy, thereby developing an avoidance of trauma that impedes healing. Strategies for reducing trauma processing may be difficult to identify effectively. This project suggests several means by which therapists can utilize the language of scripture, including scriptural narrative, metaphor, and poetry, as a therapeutic intervention with conservative Christian clients who are pursuing trauma processing. The proposed approach assists clients in explaining their traumatic events in a secure setting, hence preventing the common hyperarousal symptoms that are upsetting. The treatment can enhance the effectiveness of evidence-based practices. It incorporates several …

Walking In Promise, Living In Reality: Exploring The Mental Health Implications Of The Pentecostal Discourse Of Divine Calling, Robert D. Mcbain

Salubritas: International Journal of Spirit-Empowered Counseling

Pentecostalism places a strong emphasis on the discourse of divine calling, where individuals believe they are purposefully created, guided, and empowered by God to fulfill a specific mission. This sense of calling profoundly shapes Pentecostals’ sense of identity and purpose. Using Grounded Theory, this study analyzes open, in-depth interviews with Pentecostals in the U.S. to explore the impact of the Pentecostal discourse of divine calling on their mental health. The metaphor of ‘walking in’ one’s calling emerges as the central theme used by participants to explain the interaction between their perception of divine calling, their lived realities, and their mental …

I Am My Body: Post-Traumatic Embodying And The Unexpected Disinterring Of Childhood Spiritual Neglect, Cathy Rowan

Salubritas: International Journal of Spirit-Empowered Counseling

This autoethnographic paper investigates how an embodying approach (Focusing) unexpectedly impacts the author’s spiritual formation in the undoing of childhood relational trauma, which had resulted in a dissociative embodiment reaction. This enlivening and deepening spiritual formation process is described by means of a five-step metaphor, moving from “no-body” (dissociative disembodiment) to “I am my body” (the experience of the bodily indwelling) as her spiritual formation evolves from just intellectual belief to an embodying, experiential Christian spirituality. This life-long process is viewed through various lenses, including children’s spirituality research, trauma theology, faith development models, the writings of Thomas Merton and the …

Hoping Forward, Haley R. French

Salubritas: International Journal of Spirit-Empowered Counseling

No abstract provided.

Front Matter Salubritas 4 (2025), Editors Salubritas

Salubritas: International Journal of Spirit-Empowered Counseling

No abstract provided.

Full Issue Salubritas, Editors Salubritas

Salubritas: International Journal of Spirit-Empowered Counseling

No abstract provided.

Detection Of Chromosomal Mosaicism- The Importance Of Karyotyping And Fish, Allison Kalinousky, Jennifer L. Roberts, Madeeha Alikhan, John Herriges, Lei Zhang, Elena Repnikova

Research Days

This project evaluates the prevalence of chromosomal mosaicism in constitutional samples using conventional cytogenetic techniques evaluated at Children's Mercy Hospital during a 20-year period.

Effects Of Genetic Polymorphisms On The Oct1 And Oct2-Mediated Uptake Of Atenolol, Mollie Margaret Walton Md, Jonathan Wagner Do, Ceclia E. Villanueva Phd, Bruno Hagenbuch Phd

Research Days

This project characterizes the role of OCT1 and OCT2 on cellular uptake of atenolol and tests the hypothesis that OCT1 and OCT2 proteins with genetic polymorphisms, when expressed in vitro, will result in altered cellular uptake of atenolol relative to the reference genotype. This approach utilizes transiently transfected OCT1 and OCT2 cell assays to perform time-dependent atenolol uptake experiments to generate kinetics information. The goal is to provide a better understanding of polymorphisms associated with OCT1 and OCT2 expression and function as a means to individualize pharmacologic therapy for atenolol.

Exploring Anticoagulation Trends As Early Infection Markers In Pediatric Ecmo And Crrt Patients, Samantha Davidson, Jay Rilinger, Jenna Miller, Caroline Holton, Joshua Herigon, Brian Lee

Research Days

This retrospective cohort study at a tertiary pediatric hospital included ICU patients who developed infections after 72 hours on extracorporeal support from 2017-2023. We assessed whether the number of anticoagulation dose changes are linked to acquired infections.

Opioid Use In Third Trimester Of Pregnancy And Neonatal Morbidity And Mortality, Aleysh A. Ayala Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Diagnostic And Clinical Utility Of Oncoscan Microarray And Ngs-Based Sequencing In Pediatric Solid Tumors: Children’S Mercy Hospital’S Experience, Aravindh Nagarajan, Lisa Lansdon, Midhat Farooqi, Lei Zhang, Elena Repnikova

Research Days

This papers attempts to evaluate the diagnostic and clinical utility of microarray-based OS+ in detecting clinically relevant genetic alterations in FFPE solid tumor samples and to compare the yield of somatic mutation detection by WGS/WES in pediatric solid tumors at Children’s Mercy Hospital - Kansas City.

Maternal Obesity And Its Impact On Successful Induction Of Labor, Jonte Ellison Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Effect Of Residential Location And Natural Disaster Experience On Adverse Pregnancy Outcomes, Jordan Spencer Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

A Novel Surgical Technique For The Management Of Recurrent Thyroglossal Duct Cysts Using Dakins Solution Packing, Jay Szekely, Meghan Tracy, Janelle R. Noel-Macdonnell, Elie Khalifee

Research Days

Background: Thyroglossal duct cyst (TGDC) is the most common congenital midline neck anomaly occurring in 7% of the population more commonly in infants or adolescents with no predilection to sex. [1] This anomaly consists of epithelial remnants due to failure of obliteration of the thyroglossal duct, a structure that forms as the thyroid gland originates at the foramen cecum of the tongue and is displaced caudally, anterior to or through the hyoid bone, towards its final position in the lower neck. Successful surgical management of TGDCs requires complete removal of the cyst and the duct. Initial surgery for these lesions …

Decreasing Time To Antibiotics In Febrile Oncology Patients With Central Line In The Pediatric Emergency Department; A Quality Improvement Initiative, Abbigayle Carlson, Leslie Hueschen, Stephanie Clark, Christopher Kaberline, Joel Thompson

Research Days

Background: Oncology patients are at a high risk for sepsis, due to chemotherapy-induced immunosuppression and neutropenia as well as presence of a central venous catheter. Due to the high risk of sepsis, these patients require antibiotics within 60 minutes of Emergency Department (ED) arrival. During our baseline period, Sept 2022-May 2023, we only achieved this 38% of the time at Children’s Mercy ED.

Aim: By April 30th, 2024, we will increase the percentage of ED febrile oncology patients receiving antibiotics < 60 min of arrival from 36.6% to 80%, stratifying by race and ethnicity, to monitor for inequities.

Methods: Our outcome measures were the percentage of ED febrile oncology patients with antibiotics given < 60 min of arrival and the median time to antibiotic administration. Our process measures were the percentage of standard order-set usage and percentage of patients with critical information notes. Our balance measure was time from arrival to ED triage. We created a process map and fishbone diagram and identified several delays in antibiotics administration. We performed interventions with Plan-Do-Study-Act methodology. First, we implemented standing nursing orders to decrease the time spent waiting for a provider to order antibiotics (June 2024). Next, the outpatient oncology providers created a Critical Information Note, which directed prompt antibiotic administration prior to labs or consultation (August 2024). To engage physicians, we made this a Maintenance of Certification (MOC) project, with monthly review of run charts (Oct 2024). Next, we prioritized timely access of the patients’ central line, with a nursing script to communicate with families the importance of accessing their child’s central line as soon as possible (Oct 2024). We created a Central Line Note, identifying the type of central line and needle size required to access the line (March 2024).

Results: With the implementation of …

Examining Learner Preferences Of Teaching Techniques By Phm Attendings And Fellows On Multilevel Teaching Rounds, Sian Best, Jacqueline M. Walker

Research Days

This study describes the teaching techniques used on morning rounds by pediatric hospital medicine faculty and fellows at an academic institution, and describes reported effectiveness by learners of the various teaching strategies.

Switching Lanes: Leaving Behind Discharge Antibiotics And Laboratory Testing In Perforated Appendicitis, Seth Saylors, Cory Nonnemacher, Meredith Elman, Pablo Aguayo, Richard Hendrickson, David Juang, Irene Isabel P. Lim, Rebecca Rentea, Charles Snyder, Shawn St. Peter, Tolulope Oyetunji

Research Days

Purpose: Appendicitis is the most common surgical emergency in children with approximately 30% of patients presenting with perforation, defined as a hole in the appendix or a fecalith found in the abdomen, at time of surgery. Our previous protocol at time of discharge, with an 11% intraabdominal abscess (IAA) rate, included checking a white blood cell count (WBC) on day of discharge, with a value ≥10 serving as a trigger for additional outpatient oral antibiotics course. Beginning in May, 2023 we changed our protocol to no longer obtain WBC or prescribe outpatient antibiotics at time of discharge. The purpose of …

Time From Triage To Imaging In Stroke Activations At Children’S Mercy Hospital, Annie Altschul, Marcie Files, Jennifer Flint, Brooke Fridley Phd

Research Days

Background: Stroke affects 2-3 per 100,000 children annually. Timely diagnosis is vital to provide the highest quality care to pediatric stroke patients. Features that contribute to delays in diagnosis of pediatric stroke include complex or subtle signs and symptoms, limited exams in young children, broad differential and frequent stroke mimics, low awareness in the community, and sedating or paralytic medication use in critically ill children. The establishment of stroke activation protocols for children has led to improvements in care for pediatric stroke across numerous centers, expediting time to imaging and treatment.

Objective: We aimed to quantify the time …

But, It's Just A Uti, Gillian Long

Research Days

A case report of a 12 year old female presenting to the emergency room with rash, hematuria and shortness of breath, ultimately found to have a life changing diagnosis.

Variability In Methotrexate Metabolites In A Cohort Of Jia Patients, Nuria Lara Castillo, Mara Becker, Marc Sudman, Susan Thompson, Laura Ramsey

Research Days

Background: Methotrexate (MTX) is the cornerstone disease-modifying anti-rheumatic drug for the treatment of Juvenile Idiopathic Arthritis (JIA). While most patients receiving MTX have a favorable outcome, approximately 30% do not respond, and several experience toxic events, suggesting interindividual difference. Furthermore, evaluation of MTX response takes several months, with the risk of missing the early “window of opportunity” for treatment. Predicting MTX response prior to administration would greatly benefit these patients and their treating physicians by saving valuable time during the early stages of the disease onset. MTX is a folate antagonist and, similar to folate, it undergoes polyglutamation inside the …

What Happens After They Leave The Ed? Following Up Acute Asthma Exacerbations After Changes In Clinical Practice Guidelines For Treatment, Phillip S. Wozniak, Jade B. Tam-Williams

Research Days

In 2022, Children’s Mercy Hospital (CMH) implemented a new clinical practice guideline (CPG) recommending single-dose dexamethasone as the first line oral steroid for treatment of mild to moderate acute asthma exacerbations. We assessed the impact of this CPG change on readmission rates after discharge from emergency department/urgent care (ED/UC). We hypothesized that single-dose dexamethasone would be non-inferior to a 5-day course of prednisone/prednisolone with respect to 7-day and 30-day acute care readmission rates and need for additional outpatient steroid courses.

Bilateral Buccal Myomucosal Flap Palatoplasty For The Management Of Velopharyngeal Dysfunction In Children, Jay Szekely, Meghan Tracy, Janelle R. Noel-Macdonnell, Jill M. Arganbright

Research Days

Background: The use of bilateral myomucosal buccal flap palatoplasty (BMBFP) for velopharyngeal insufficiency (VPI) has increased in popularity. Despite the increasing popularity, there is a paucity in research examining their outcomes, especially in reference to the pediatric population.

Objectives/Goal: The objective of this paper was to investigate the utility of BMBFP for the correction of VPI in children.

Methods/Design: Retrospective chart review was performed using CPT codes to locate patients with BMBFP performed at our pediatric institution between July 2020 to July 2024. Data collected included demographics, associated syndromes, complications, pre-operative and post-operative resonance outcomes, and the need for revision …

Posterior Pharyngeal Flap For The Management Of Velopharyngeal Dysfunction: Comparing Outcomes For Children With 22q11.2 Deletion Syndrome To Those Without, Jay Szekely, Meghan Tracy, Janelle R. Noel-Macdonnell, Jill M. Arganbright

Research Days

Introduction (including objectives): Velopharyngeal dysfunction (VPD) is one of the most common clinical features of 22q11.2 deletion syndrome (22q11.2DS) and often requires surgical intervention; due to the multifactorial nature of VPD, these patients present unique and often complex surgical challenges. Prior studies have generally demonstrated poorer speech outcomes postoperatively in children with 22q11.2DS. The posterior pharyngeal flap (PPF) is often considered first-line surgical choice for correction of VPD in children with 22q11.2DS. The aim of this study is to compare PPF outcomes for children with 22q11.2DS to those without.

Methods: Retrospective review for pediatric patients diagnosed with VPI who underwent …

Viral Detection In Anterior Nasal Swabs Versus Nasopharyngeal Swabs In Children, Nicole Neeley, Abby Kietzman, Rangaraj Selvarangan, Dithi Banerjee, Jennifer Goldman, Jennifer Schuster

Research Days

Background: Respiratory viruses are a significant cause of pediatric illness and healthcare utilization. Diagnostic testing for respiratory viruses is generally performed using nasopharyngeal (NP) specimens obtained by trained staff, limiting testing to medical settings. Evaluating additional sampling methods in children that are easier to collect and can be performed outside of medical settings, such as anterior nasal swab (NS) specimens may expand access to diagnostic testing and aid public health surveillance.

Methods: Eligible children hospitalized at Children’s Mercy Hospital who had a standard of care NP specimen collected for respiratory viral testing were enrolled. Research NS specimens were obtained through …

Outcomes Of Expectant, Medical, And Surgical Management Of Early Pregnancy Loss, Sylvia Lobo Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Oligohydramnios As A Potential Risk Factor For Postpartum Readmission For Hypertensive Disorders Of Pregnancy, Rachel Denneny Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Systematic Review And Meta-Analysis Of Administration Of Liposomal Bupivacaine For Opioid Reduction After Cesarean Delivery, Madelyn Roberson Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Comparative Analysis Of Frozen Embryo Transfer Protocols In Patients With And Without Ovulatory Dysfunction, Juan Naranjo Md

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.

Stage I Hypertension And Aspirin Use In Pregnancy, Keiko Leong Md/Mph

Dept. of Obstetrics & Gynecology Resident Research Day

No abstract provided.